RT Journal
A1 Deck KB, Berne TV
T1 SElective management of subphrenic abscesses
JF Archives of Surgery
JO Archives of Surgery
YR 1979
FD October 1
VO 114
IS 10
SP 1165
OP 1168
DO 10.1001/archsurg.1979.01370340071012
UL http://dx.doi.org/10.1001/archsurg.1979.01370340071012
AB • Although extraserous drainage of subphrenic abscesses has gained wide acceptance, there is some renewed enthusiasm for the more frequent use of a transperitoneal operation because it affords the opportunity to discover unsuspected pathologic conditions, particularly heterotopic abscess. In 44 patients with postoperative subphrenic abscesses, the approach to drainage was selected on the basis of the clinical circumstances. Among 28 patients whose abscesses were drained extraserously, the incidence of heteroptic and recurrent abscesses was low. No serious complications of peritoneal or wound soilage occurred after transperitoneal drainage in 16 patients, yet the problems of inadequate drainage and heteroptic abscess were not eliminated. Celiotomy prior to definitive abscess localization was required for 13 patients. Five patients died. The operative approach should be based on the clinical assessment of the patient and particularly on the probability that multicentric intra-abdominal pathologic conditions exist.(Arch Surg 114:1165-1168, 1979)